A patient with kidney failure is prescribed a medication that is primarily excreted through the kidneys. Which of the following statements is most accurate regarding the pharmacokinetics of this medication?
Hepatic metabolism will fully compensate for the decreased renal excretion
Dose adjustment may be necessary to prevent drug accumulation
The medication's half-life will likely be shorter due to decreased renal function
The risk of drug toxicity is decreased due to impaired excretion
The Correct Answer is B
A. Hepatic metabolism will fully compensate for the decreased renal excretion: This is inaccurate. While the liver may play a role in metabolizing some drugs, it cannot fully compensate for reduced renal clearance of medications that are primarily excreted by the kidneys.
B. Dose adjustment may be necessary to prevent drug accumulation: In patients with kidney failure, reduced renal clearance slows the elimination of renally-excreted drugs. Without dose adjustment, drug levels can build up, increasing the risk of toxicity. Dosing must be tailored to the patient’s renal function, often guided by creatinine clearance or GFR.
C. The medication's half-life will likely be shorter due to decreased renal function: The opposite is true. Impaired renal function slows drug excretion, prolonging the drug’s half-life, which means the drug stays in the system longer and can accumulate to toxic levels if not adjusted.
D. The risk of drug toxicity is decreased due to impaired excretion: Impaired excretion increases, not decreases, the risk of toxicity. Renally-excreted drugs that are not properly cleared can accumulate and reach dangerous concentrations in the bloodstream.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","E"]
Explanation
A. Beta-blockers like metoprolol can mask the signs of hypoglycemia: Metoprolol can blunt adrenergic symptoms such as tachycardia and tremors, which are key warning signs of hypoglycemia. This is especially concerning in diabetic patients who rely on these symptoms for early detection of low blood glucose.
B. It is safe to take additional doses of Sertraline if the patient feels like their symptoms are worsening: Sertraline, a selective serotonin reuptake inhibitor (SSRI), must be taken exactly as prescribed. Taking extra doses increases the risk of serotonin syndrome, which can be life-threatening and requires medical supervision for dosage adjustments.
C. The patient should be monitored for orthostatic hypotension: Older adults taking medications like metoprolol and triazolam are at increased risk for orthostatic hypotension due to vasodilation and CNS depression. Monitoring helps prevent falls and syncope, especially when changing positions.
D. Oxycodone can be used long-term without risk of physical dependence: Oxycodone is an opioid analgesic and carries a high risk of tolerance, physical dependence, and addiction when used long-term. Even when used appropriately, patients can develop dependence, necessitating careful monitoring.
E. The combination of triazolam and oxycodone increases the risk of respiratory depression: Both drugs are CNS depressants, and their combination can have a synergistic effect on respiratory centers in the brain. This raises the risk of severe respiratory depression, particularly in older adults or those with underlying respiratory conditions.
Correct Answer is D
Explanation
A. 300mg is incorrect.
B. 400mg is incorrect
C. 200mg is incorrect
D. The half-life of a drug is the time it takes for the plasma concentration of a drug to decrease by 50%. If the half-life is 6 hours, the amount of drug in the body will halve every 6 hours.
- Initial dose: 800 mg
- After 6 hours (1st half-life): 800 mg ÷ 2 = 400 mg
- After 12 hours (2nd half-life): 400 mg ÷ 2 = 200 mg
- After 18 hours (3rd half-life): 200 mg ÷ 2 = 100 mg
After 18 hours (three half-lives), 100 mg of the medication will remain in the patient's system.
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